Faith-based healthcare is offered through 501(c)(3) nonprofit charities with a religiously-oriented purpose, and serve as alternatives to health insurance. These plans are often referred to as “health sharing ministries” or “healthcare sharing ministries.”
How Does Faith-Based Healthcare Work?
Unlike traditional health insurance, these plans do not “insure” people but rather “share” healthcare costs among a large pool of people. Members pay into the system and upon receiving a bill from their physician other members of the plan will contribute to help pay the bill.
Functions Similarly to a Credit Union: The underlying philosophy is similar to that of credit unions. Faith-based healthcare, like credit unions, are community-oriented and membership-driven non-profits. So, let’s say Jake is a member of a faith-based health plan. Jake will contribute a monthly fee – a fee that would be much lower than a traditional insurance premium – and, if Jake gets sick, the rest of the members of his faith-based healthcare will contribute money towards his bill.
Does Faith-Based Healthcare Cover Essential Health Benefits?
Faith-based healthcare is not ACA-compliant and does not have to cover the essential health benefits mandated by the Affordable Care Act (ACA). These plans are grandfathered into the ACA. This means that enrollees are exempt from the individual mandate penalty usually associated with non-ACA plans.
ACA does set certain requirements for faith-based health plans:
- Members must share a common set of beliefs;
- The plans must share medical expenses among members regardless of state residence;
- Members can’t lose their membership even if they develop a medical condition – although, members who don’t pay their share of costs can be disenrolled; and
- The plans must be audited, with audits publically available.
Can Health Saving Accounts (HSAs) Be Used in Conjunction with Faith-Based Healthcare?
How Many Plans Are Out There?
There are four major healthcare sharing ministries that qualify for exemption from the Obamacare penalty:
- Christian Healthcare Ministries;
- Samaritan Ministries; and
- Liberty Healthshare.
Altrua Healthshare, Anabaptist Healthshare and Solidarity Healthshare also qualify for the exemption from the Obamacare penalty.
There are more than 100 other faith-based health plans that do not qualify for the exemption, most of which are organized by small local churches.
How Strict Is the Religious Requirement?
The religious requirement depends on which faith-based health plans you choose to go with. Faith-based health plans typically ask their members to sign a statement of faith, and some check for proof from your local church. Liberty Healthshare is known to be open to non-evangelical Christians as members and only requires members to sign a statement of faith based on biblical principles that, hypothetically, non-Christians might also ascribe to.
Are There Premiums or Deductibles? How Much Do They Cost?
Monthly Sharing Amounts: Premiums are referred to as “monthly sharing amounts” and usually range from around $100 to $500 depending on your plan and size of family.
Sharing Responsibilities: Deductibles and other out-of-pocket costs are called “sharing responsibilities” and can be as low as $500 to as much as $10,000, depending on your plan.
Also, in addition to monthly sharing amounts, most plans require a small enrollment fee. In most scenarios, these total costs remain far lower than traditional insurance costs.
What Does Faith-Based Healthcare Cover?
The specifics of what faith-based healthcare will or will not cover varies on your plan and on each given circumstance.
Here is a general breakdown of what plans will and will not cover:
Can I Be Denied Coverage?
Yes. Since faith-based health plans are not bounded by the Affordable Care Act, people can be denied coverage based on pre-existing conditions or for religious beliefs.
Will I Be Able to Keep My Doctor?
Yes, healthcare sharing ministries do not have networks and allow you to see any doctor you choose.
What Are the Advantages of Faith-Based Health Plans?
There are several important advantages of using faith-based healthcare as an alternative to traditional health insurance.
- Affordability: These plans are usually more affordable than traditional health insurance, especially plans in the unstable Obamacare market. Additionally, donations which come in from other members are considered “gifts” which are tax-free.
- Keep Your Doctor: You can keep your doctor as there are no separate in-network and out-of-network costs.
- No Obamacare Penalty: You are exempt from paying the individual mandate penalty imposed by the Affordable Care Act.
- Belief-Driven Healthcare: If you are a person of faith then this plan allows you to contribute money to an organization whose beliefs you share without worrying about helping to fund care such as abortions, gender reassignment or morning-after pills.
- Community: There is a sense of community within these faith-based plans that is absent with traditional health insurance companies. If you are diagnosed with a serious medical condition you can expect your health sharing ministry to care for you physically and emotionally, not just financially.
What Are the Risks?
There are important risks to be aware of when considering faith-based healthcare:
- Don’t Have to Cover Essential Health Benefits: Since these plans are not ACA-compliant they don’t have to cover essential health benefits such as preventative care or mental health care.
- Denied Coverage: You can be denied coverage for pre-existing conditions or for certain religious beliefs.
- Belief-Driven Healthcare: Your faith-based health plan may not contribute towards injuries related to an accident that was caused by immoral reasons such as drinking alcohol or using illicit drugs.
- Running Out of Funds: Since these plans “share” costs and don’t insure members, you are not guaranteed coverage. Technically they can run out of funds, go bankrupt and fail to contribute towards your costs. This outcome, though, is unlikely.
Are Faith-Based Plans Subject to Regulation?
It depends on the state. 30 states have instituted safe-harbor laws that differentiate between health-sharing ministries and health insurance companies. This prevents state regulators from enforcing strict laws against faith-based health plans. In the map below from the Alliance of Health Care Sharing Ministries, the states in light green have safe-harbor laws in place, while those in dark green have some other kind of regulatory exemption for healthcare sharing ministries.
How Many People Are Enrolled in Faith-Based Healthcare?
There are more than 1 million Americans enrolled in faith-based health plans according to the Alliance of Health Care Sharing Ministries.
When and How Can I Enroll in Faith-Based Healthcare?
You can enroll online with any of the major health sharing ministries listed above. You can enroll at any time you want – there is no open enrollment period for faith-based health plans.
Taking the Next Steps
You can evaluate your health coverage and see if it’s the best option for your needs.
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